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Thyroid UK
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Anxiety on T4/T3 combo post thyroidectomy

Has anyone experienced anxiety on T4 100 umg and T3 umg combo?

Three months on it now. Was feeling great but have started to suffer some anxiety. Am also on Sertraline 100 mg for OCD/anxiety.

Had my thyroid removed three months ago and am due to take a blood test this week.

Any advice would be gratefully received x

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How much T3 are you taking? You're probably under-medicated. Anxiety is a hypo symptom.

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Hi Greygoose I am taking 25 umg. Will post blood test results when they come back. Thank you for your response.

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You're welcome. :)

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I'm sorry you've had your thyroid gland removed and hope the endocrinologist is kind and knowledgeable.

Blood test should always be at the very earliest, fasting (you can drink water) and allow a gap of 24 hours between your last dose of thyroid hormones and the test and take afterwards. This help keep the TSH at its highest as it drops throughout the day and may mean you don't get an increase you need.

Post the results with the ranges and members will respond.

When symptoms return it usually means we need an increase in hormones. I do hope your doctor tests the FT4 and FT3 (many don't) but these are more informative and I'll post an excerpt from the following link:-

"FT4 = FREE T4

Thyroid hormones not bound to proteins. FT4 lowers when the thyroid is struggling.

The approx. reference range for this test is 10 to 24

FT3 = FREE T3

T4 converts to T3 and is the only thyroid hormone actually used by the body's cells.

The approx. reference range for Free T3 is 4 to 8.3

We at Thyroid UK believe that you need to know your Free T3 level too because this will often show low if you are not converting, and high if you have blocked receptor cells. Even if you are converting, the body needs the extra T3 that a normal thyroid produces. There has been some research to show that people feel better on a mixture of Thyroxine (T4) and Triiodothyronine (T3). Effects of Thyroxine as Compared with Thyroxine plus Triiodothyronine in patients with hypothyroidism – The New England Journal of Medicine Feb.11, 99 Vol. 340. (Click here for this article). "

thyroiduk.org.uk/tuk/testin...

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Thank you Shaws x

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I get paranoia occassionally on combo. Usually means I have deviated from my regime. I take t4 50, t3 20 1st thing, the t3 10mg at lunch (before food) and t3 10mg in the afternoon as t3 is short acting. Maybe try splitting your dose?

You may also be over/under medicated.

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Thank you for your response. Are you saying that you take 10 umg first thing and then 10 umg again of the T3 or are you saying that you take 20 umg first thing, then 10 umg and then 10 umg again? I will try to split my dose today as I did think that might be an issue having read some other information on this forum.

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I take 20umg in the morning, then 10umg, then 10umg.

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Thank you. I will try to split my T3 in three today to see if it makes a difference.

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Remember, empty stomach 😁

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Thank you Princessbubbles. So I should split the T3 into three doses and on an empty stomach. So how long after/before food should I be taking these doses please?

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All your medication should be taken on an empty stomach (double check the packaging for clarity). This includes your morning cup of milky tea 😂.

An hour before eating is what I was told and at least 1 - 3 hours after eating.

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T3 is absorbed into our system quickly, but its action then begins and it sends out 'waves' of that one dose which last between one to three days. I take my T3 once daily as it has to flood the T3 receptor cells first. This scientist took his T3 of 150mcg daily in the middle of the night. Definitely nothing interfered with the uptake.

web.archive.org/web/2010103...

jaxie28

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My Endo said to try and split it and it works for me. Otherwise I get a massive slump c.3pm. At the end of the day it's finding what works for the body.

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Thank you x

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Yes - it is what suits the person. The only thing with splitting is that we have to make sure our stomach is completely empty and it can interfere with our lifestyle. I take mine once daily - I have no slumps and am fortunate to feel well. Dr Lowe (scientists/researcher) himself took 150mcg once daily in the middle of the night and he was an expert in both Thyroid Hormone Resistance and hypothyroidism and Metabolic Syndromes. All of his patients took one daily dose of either NDT or T3 only.He'd never prescribe levothyroxine.

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Thank you Shaws x

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Thank you Shaws x

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Ask doctor to check calcium, vit D and parathyroid hormone levels to rule out calcium imbalance which can cause anxiety.

Have you always taken sertraline or is it something new?

Thyroid imbalance and incorrectly treated or incorrectly medicated thyroid conditions can cause OCD like symptoms and anxiety.

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Thank you for your response Nanaedake. I have had these symptoms for at least 25 years so I don't know if they are thyroid related or not to be honest.

I am taking a Blue Horizon thyroid check plus 11 blood test in the next few days. I do take Vitamin D daily and my parathyroid hormone levels came back okay about two months ago so my Endocrinologist told me to stop Calcium. Do you think this should be retested?

Probably need to post blood test results on here to get a clearer picture?

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